[1]康振峻,宋治远,姚青,等.经导管封堵治疗成人巨大房间隔缺损的临床疗效及其安全性[J].陆军军医大学学报(原第三军医大学学报),2011,33(08):838-840.
　Kang Zhenjun,Song Zhiyuan,Yao Qing,et al.Evaluation of clinical effect and safety of transcatheter closure on adult large atrial septal defect[J].J Amry Med Univ (J Third Mil Med Univ),2011,33(08):838-840.
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
33卷
期数:
2011年第08期
页码:
838-840
栏目:
论著
出版日期:
2011-04-30

文章信息/Info

Title:
Evaluation of clinical effect and safety of transcatheter closure on adult large atrial septal defect
作者:
康振峻; 宋治远; 姚青; 仝识非; 李永华; 李华康; 张志辉
第三军医大学西南医院心血管内科，重庆市介入心脏病学研究所
Author(s):
Kang Zhenjun;  Song Zhiyuan;  Yao Qing;  Tong Shifei;  Li Yonghua;  Li Huakang;  Zhang Zhihui
Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
关键词:
经胸超声心动图; 封堵器; 巨大型房间隔缺损
Keywords:
transthoracic echocardiography;  occluder;  atrial septal defect
分类号:
R540.46;R541.105
文献标志码:
A
摘要:
目的    通过对巨大型房间隔缺损（atrial septal defect ，ASD）封堵术后的随访观察，评价经导管封堵ASD的临床疗效与安全性。    方法    选择在我科成功进行经导管封堵治疗、ASD直径在30mm以上并完成1年以上随访的87例患者为研究对象，分别记录患者术前、术中及术后随访资料，分别术后3d、1、6个月及1年各查心电图及经胸超声心动图（TTE）1次，并对所有资料进行回顾性分析。    结果    87例ASD患者TTE测量ASD直径30~38(33.8±1.85)mm，置入封堵器直径36~42(39.2±1.38)mm。术中2例发生一过性Ⅰ度及Ⅱ度房室传导阻滞，1例发生一过性窦性心动过缓。在长达1年的随访期间，所有患者右心房、右心室内径均明显缩小(P<0.05)，左心室舒张末期内径则逐渐增大，但仍在正常范围。随访1年时，2例患者遗留完全性右束支传导阻滞，无严重并发症发生。    结论    经导管封堵巨大ASD安全、有效，术后右心房及右心室可逐渐恢复正常，达到根治ASD之目的。
Abstract:
Objective    To evaluate the clinical effect and safety of transcatheter closure on adult large atrial septal defect (ASD) through the follow-up observation.     Methods    Eighty-seven patients having received the transcatheter closure for ASD (diameter >30 mm) in the our department, and been followed up for more than 1 year were enrolled as the subjects. The patients were examined by electrocardiography (ECG) and transthoracic echocardiography (TTE) before and 3 d, 1 month, 6 months and 1 year after the operation. The patients were also monitored by ECG and TTE during the operation.     Results    The patients had an average ASD diameter of  30-38 (33.8±1.85) mm before the transcatheter closure. The occluders that were implanted in the patients during the operation had an average diameter of 36-42 (39.2±1.38) mm. First- and second-degree atrioventricular block occurred in 2 cases, and transient sinus bradycardia occurred in 1 case during the operation. In the follow-up period, the inner diameters of right atrium and right ventricle decreased significantly and fell within the normal range in all cases (P<0.05); the end-diastolic inner diameters of left ventricle increased gradually, and yet were still within the normal range. One year after the transcatheter closure, only 2 cases had complete right bundle branch block without severe complicating diseases.     Conclusion    Transcatheter closure is an effective and safe means of curing large ASD.

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更新日期/Last Update: 2011-04-13